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. 2022;98(5):873-877.
doi: 10.1080/09553002.2021.2013573. Epub 2021 Dec 13.

Preparedness for a 'no-notice' mass-casualty incident: a nuclear detonation scenario

C Norman Coleman  1   2 , Kenneth D Cliffer  1 , Andrea L DiCarlo  3 , Mary J Homer  1 , Brian R Moyer  1 , Shannon G Loelius  1 , Adam W Tewell  1 , Judith L Bader  1 , John F Koerner  1
Affiliations

Preparedness for a 'no-notice' mass-casualty incident: a nuclear detonation scenario

C Norman Coleman et al. Int J Radiat Biol. 2022.

Abstract

Purpose: An effective response for a mass-casualty incident requires understanding the relevant basic science and physical impact; detailed preparedness among jurisdictions; and clear, sequential response planning, including formal operational exercises, logistics, interagency, and public-private coordination, rapid activation of resilience, and continual improvement from lessons learned and new knowledge. This ConRad 2021 meeting report describes steps for civilian medical and public health response planning for a nuclear detonation; the utility of this type of planning for broader application; and extension of this planning to the international community.

Conclusion: A nuclear detonation requires a response within minutes to what will be a large-scale disaster complicated by radiation, including some elements that are similar to a broad range of incidents. The response could be further complicated if multiple incidents occur simultaneously. Required are detailed planning, preparedness and scripting for an immediate operational response, addressing clinical manifestations of evolving radiation illness, and flexibility to adapt to a rapidly changing situation. This need translates into the use of just-in-time information; effective, credible communication; situational awareness on a global scale; and a template upon which to apply capabilities in a multi-sector response. This effort is greatly facilitated using a 'playbook' approach, the basics of which are presented.

Keywords: Response; disaster response; emergency playbook; mass-casualty; nuclear detonation; radiation accident.

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Figures

Figure 1.
Figure 1.
Operational phases and need for science expertise, planning, and cross-cutting capabilities relative to the incident.
Figure 2.
Figure 2.
Time periods and functional areas. *The time periods as listed here can be considered to correspond to FEMA phases (FEMA 2016): phase 1 (pre-incident), phase 2a (immediate response), phase 2b (deployment), and phases 2c/3 (sustained response/recovery).
See this image and copyright information in PMC

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